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tv   [untitled]    September 5, 2010 4:30am-5:00am PST

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have a treatment plan. it is pretty much the same. the distinction is the civil process that allows earlier intervention for people with a history. in a few moments i have left, i wanted to put a few other things on the record. there is a voluntary settlement agreement. there is a misnomer that someone bypasses the court process. if voluntary settlement agreement is court order. the person just forgoes the hearing if they agree to it. i do not need to go to the hearing and have a contested adversarial proceeding. it is not only a civil procedure which is an early intervention tool, but it allows people to live in their homes in the community instead of inpatient treatment. you need to keep that in mind. maybe i will wrap up with this. patient attitudes and quality of life have been studied with
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kendra's law in new york. people appreciate having their lives given back to them. [tone!] some people talk about stigmatizing and running from services afterwards. the data does not bear that out. i urge you to support this measure in san francisco. >> my name is star when olson. and a friend of california mental help clients. i am speaking from my own observation. what concerns me about the law is the medication and how it is given. from my observation with family members, it seems they get over medicated.
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they do not understand what is going on after that. they can rarely -- barely walk or talk because of the medication. as much as i feel for them, i lost my youngest son last year. that was through his own hands. my concern is who will be watching or regulating if this does pass the doctors and clinicians medicating the patients. a lot of times, they're way over-medicated. you can go to the clinics and see that. my mother worked at eps in santa clara county as an emergency escort. she got involved because of the over medication of patients. that is my basic concern. a lot of pharmaceutical companies are pushing their drugs on to the doctors and whatever. i just want to make sure that someone is aware of what is going on in these
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establishments with the over medication of patients. >> supervisor chu: thank you. if there are any other public speakers, please line up or we will conclude public comment. >> i am a parent of the consumer who's doing really well, fortunately. the point i would like to make is he is doing well for several reasons. he has had a choice of medications with his psychiatrist to choose the medication that best fits him and also to work on the dosage. he is going down right now. he is doing really well. all of these medications have severe side effects. they make him feel not very well. -- they make him feel not very well all the time. if this law is passed, and like to see that the patients have the ability to work with a psychiatrist.
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it is important for them to be empowered and have self- determination as well and to have and holistic approach to mental illness and not just medications. my son is doing really well. he is going to school. he is been helped with job training and placement. he is doing exercise. he has safe housing. he has medication. it is a whole package, not just the medications. it is really very important that the patient have a say on their treatment. thank you. supervisor chu: let me make one comment. it has been set a few times. -- it has been set a few times. you can stay or set them -- sit down. laura's law does not require medication. it certainly does not allow for forced medication. under any law in the united states, it has to be given in a licensed medical facility.
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we're not talking about people out in the community just passing out drugs. what is so important and vital about the program is that some patients may need a vacation. they have to go through a hearing and a number of steps to get it. or they do not. if they do not, aot helps them through that. the consumer does have choices. they do have a say. we've heard a lot about force. this is not about shoving something down someone's throat. it is about taking them out of a situation where they could wind up in jail or something will be forced on them and putting it into a setting that is more independent where a patient does have more say, particularly those who are very sick. supervisor alioto-pier: when you look at statistics, people with
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schizophrenia and bipolar three times more likely to be in prison than hospitalized. those are people who should not be in prison. they need to be in hospitals. they need to have the type of attention to take care of themselves. putting them in the prison is going to exacerbate a problem. it will make it worse. they will never heal from it. laura's law is essentially about taking people at high risk with schizophrenia and bipolar, we're talking about serious diseases. it is pulling them out of the jail system and putting them into an aot. you are not even in a hospital. you have a treatment program outside the hospital to take care of it. that is just mental health. when you look at the disabled community in general, last thing someone with a disability once is institutionalized care.
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the last thing people want is to be ostracized. this is about gaining independence. this is not about being institutionalized. this is about living in an institutionalized life. with this program and a zerot services are about is dealing with mental illnesses in that same way. we've gone so far away from institutionalizing people. you cannot do that now. we're more focused on in home care and services for the physically disabled. while we have moved so far with the physically disabled, we have left the mentally disabled far behind. laura's law pulls in a lot of these theories that we know are accurate and true. the oregon plant back in 1992 listed ihhs services as the number one need for people with disabilities. and yet the mental health community was left with back.
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career 20 years later talking about establishing -- here we are 20 years later talking about establishing the same programs for mental illness to help people obtain the levels of independence that they need. [applause] i want to make that clear. kelly? come on up, officer. we're still in public comment. >> i want to respond to that. my concern about whether there is mandated or forced medication through laura's law -- it obviously does not exactly mandate it. but the treatment for people have psychosis, a schizophrenic, or bipolar involves medication. if there is a treatment plan mandated, it will mandate medication as part of the plan
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for those types of illnesses. in a way, we are creating a mandated form of medication through that process. it may be a two-step process to get there, but it is a mandated type of medication. that is my consent about this. that is my concern about wanting to approver resolution that would accept laura's law of the law of the land in san francisco. i do not feel comfortable with that. i know we still have cpublic comment, but i felt i needed to respond. supervisor avalos: supervisor alioto-pier: during the last hearing, judge anderson testified about how the program works. let me read a bit of his testimony. it is interesting and important to note that none of this is done haphazardly.
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we're talking about a section of the population that incorporates people schizophrenia and bipolar. it is a very small percentage of what we're talking about. in situations like that, we have found that when people are off their mends that they do not always want to have that push. in most cases, the city would get proposition 3 funding for voluntary services only. forced or involuntary, that is not our focus. we do not receive benefits as the county for that. what happens in most cases is that people go into these programs. we can still have hearings. right now, you get if hearing. a hearing if you are locked up in jail. you go back and may still be locked in jail. if you get a hearing before you get locked up, there is hope it
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will not happen and someone will not be incarcerated. they are very strict guidelines for the increase hearing. you have to go in front of the judge. you are actually in court. supervisor avalos: what would trigger someone having to go to a lrees hearing? supervisor alioto-pier: let me finish this and then officer dunn can talk about it. he was described in nevada as simple and straightforward. the petition as bob with the director of behavioral health and nevada county. the director examines the petition to determine if the criteria has been met. it has been met, a petition is filed with the court. the clerk of the court schedules a hearing at 4:00 on that date or the following day. the public defender is notified
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so there will be council available for the consumer. we have had conversations with the public defender who represents people right now in our behavioral court system. they are very supportive. the personal defender who does this is very supportive. i am not at liberty to discuss her because she has not had an opportunity to talk to the public defender about it. the attorney likes the blade -- the way the behavioral court system works. before the hearing, a discussion as had with the individual. the proposed treatment plant is explained. they get input into whether it should be modified. if they agree with the treatment plan, there is a settlement. no hearing is conducted. if they do not agree and wish to contest the treatment plant, a hearing is conducted. the hearing takes about 20 minutes. the order is issued or not issued. the provider report regularly to the courts on the individual's progress and program. since laura's law was
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implemented in 2008, six petitions have been filed with the court. there have been 22 referrals. only one has resulted in an actual hearing. all but two resulted in accepting voluntary treatment. the numbers are showing it works. the idea of force, in most cases is not at all. one of the speakers said that choice is essential for recovery. this is about choice, independence, giving people the opportunity to use a lot of the services we currently have that they do not qualify for because they have not committed a crime. we have all of these city services but the only way to reach them is to break the law. with laura's law, we're opening up the services so that people can use them and take advantage
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of them without having to go to jail first. [applause] supervisor chu: i would like to ask the crowd to refrain from applause. i would like to finish a public comment. supervisor avalos: there are a lot of services the city provides that could get people into treatment that are not mandated. people can access them at various points. they can access it through police officers, resource centers, a formal network. they can get access to services. there are ways to get people involved in treatment in the city. the city has a broad array of those services. that is compared to nevada county, especially. they're concentrated around the city and allow for greater access than laura's law would
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create. i do not think it is an apples to apples comparison between san francisco and nevada. we do have a strong network that creates the possibility for assistance for people who need that kind of support, there, and medication as well. supervisor chu: officer dunn -- lets have members of the public finnish public comment first. i see there is one more person to speak on public comment. if any other individuals have not had their names called gatt and would like to speak -- called yet and would like to speak, please lineups' we have a sense of how many. >> i am officer kelly dunn with the psychiatric liaison unit.
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we do have an amazing amount of services in the city. they are wonderful. i started at napa state hospital on the criminally insane unit. i was a technician there prior to coming into the police department. i worked there before i came into the city. a couple of things were discovered. i want to share a few quick profound stories. there was only the -- there was a lady who had to go into the i see you. this was when i was in mobile crisis. the reason why was because her beliefs system said it should all of our nutrients from the sun. she lived in pacific heights. she had a bunch of money and a beautiful home, but she was slowly killing herself. i understand the scariness of forcing people to take medication. on the other side of that, i dealt with the transgendered
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person who had a belief system that someone was the devil. she almost stabbed someone to death. after medication, she was able to comprehend what she had done. she committed suicide. i understand your thoughts about forcing medication. to assess who is completely out of touch with reality, it to make a decision about what is best for them when they think that the sun will provide all of their food or that a random stranger walking down the street as the devil and has to be killed does not work for me. everyday i have to read police reports of crimes that happen. i get all of the police reports related to mental health and criminal stuff in san francisco. it makes me very sad to think that they believed what they were doing to be completely
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true. then they have done something that can never be taken back. it was because of them not being able to be cha -- properly treated medically. i have seen that people are not forced with medications. it is a very small number. you have to be literally physically out of control trying to hurt someone else or yourself to a level of gravely disabled where you are not even able to care for your basic needs. supervisor chu: thank you. >> good afternoon. in 1981, and is diagnosed with bipolar disorder. since then i have suffered approximately seven years where i was completely incapacitated, unable to work for take care of myself. the idea that people with mental
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illness are refusing treatment because of their mental illness is not totally true. i have had to make decisions since 1981 about sacrificing my physical health in order to take the medications that are going to help me manage my bipolar disorder. as a result of that, i now have the essential tremor. it is incurable. i have metabolic syndrome. that is a host of conditions known to be caused by psychiatric medications. i have had to make those choices. these are some of the reasons why people with mental illness suffered shorter lifespans. it is not simply because they are mentally ill. is because the treatment that is available to them at a price -- comes at a price. i have sat in help commission meetings for the past three years during budget times.
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time again, people from various community agencies have come up to argue that their program is going to save money. that argument has rarely held sway with the commission, with the exception of the mayor's proposal to create the health court he was in favor of. the argument that they were going to save money suddenly became an invalid one -- a valid one. this is hypocrisy. public policies are not necessarily about helping people as much as getting them through that system in the same way that public education to get people through a system without teaching them to learn to read or write. there is no exit strategy for the system. there is no way of people graduating into a truly
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independent life. dph acknowledged this two years ago. [tone!] their strategies have been about cutting exactly the kinds of services we're talking about. citywide, there's a huge cut proposed. it is true we have lots of resources. they are not coordinated. the safety net is defined differently depending on who you ask. ultimately, it is a morass in which the greatest struggle for someone with mental -- [tone!] -- making their way through that system. supervisor chu: are there any other comments? with that, public comments are closed. let me just say supervisor avalos mentioned that nevada
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county and san francisco do not think we did do things exactly the same way. part of what this legislation does is it means sitting down with public health and figuring out how sentences would navigate through the system. to give you an idea of how said francisco -- and figuring out how seven cisco would navigate through the system. -- house and francisco would navigate through the system. -- it would help us figure out how san francisco would navigate through the system. please come up here. let me ask my colleagues to go one at a time. supervisor alioto-pier: it is very interesting. my understanding is that everyone shows up in the morning to go in front of the judge in her chambers. they sit down with the public defender and attorneys for the
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clients. could you walk us through how that works? >> in favor of course, we in the treatment team that includes the judge, district attorney, probation, and jail psychiatric services and city what providers. -- and behavioral health court. the judge says it is about treatment. she does not want to hear from the lawyer. she wants to hear from the commission -- clinician. we give progress reports about whether they're going to groups and taking their medications, whether they are using drugs or not, how far they have gotten in getting a job. we then give recommendations to the judge on whether they should get on the honor roll or have sanctions. the judge might have them come to court more frequently. jail is definitely not used as a
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sanction. we do not remand people for not complying with treatment. people that are remanded, it is because they are violent and do not quite meet the 5150 criteria but are a threat to public safety. the clients come to court at 2:00 p.m. the judges on the bench. the clients come to the bench for a conversation between the judge and the client. the clients and develop a relationship with the judge. -- the clients develop our relationship with the judge. they want to please her. the judge tells them what she wants. they take it seriously. our judge who has been there three years is leaving. i told her how important this relationship the judge has with the clients is. she spent the last three weeks talking to judges about her -- talking to the clients about leaving. the clients are bringing her flowers. bair said she is leaving.
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she has become part of their support system. there was a study done on mental help courts in the nation. ours was one of them. there was a questionnaire with clients on how coercive they felt their treatment was while they were in these mental health courts. almost 100% felt that the treatment was not coercive. they felt they were choosing to be in the court or not. they felt like they were choosing their treatment. the overall satisfaction of the clients was that they felt they had better lives because of being in this court. supervisor alioto-pier: this is pedro court. they broke the law to get there. it was not a done deal that they automatically got in. we have limited resources in behavioral court. not everyone with mental on the skids to go through that
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process. a lot of people with severe mental illness and up in jail. they are not receiving the types of treatments in jail that matter. >> the goal is to keep these people in the community in a safe way. the goal in graduating from the haverhill held court is that the judge expects them to be engaged in productive activities like jobs, volunteer work, and school. it is not about just taking medications. it has become a minor piece of that. as long as their behavior is good and they are engaging, they are engaging in life. when a lot of people do not take medications, they do not engage in life. they deteriorated quickly. they become incapacitated or violent to themselves or others. supervisor chu: all right.
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thank you. i have some amendments. i am not sure if we took them. supervisor chu: i know there is an amendment to strike some lines from page 23. you have made a motion to do that. is there any objection? without objection, the amendment is made. now to the amended legislation. supervisor alioto-pier: i would like to make a motion to send this to the board with recommendations. thank you, supervisor avalos, for your comments today. i appreciate them. in a city like san francisco, particularly one where we put a lot of time and energy into our homeless programs, affordable
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housing, and a lot of things to try to help people get off the streets -- when i first heard laura's law laura's, he was only a few months ago. it seemed to be the missing piece to the san francisco puzzle of how we would help people get off the street. it is not just about -- you cannot give someone housing if they cannot hold down a job and pay for their rent. it seems to be a cycle. i have seen this in my work with the disabled community for years. i have been doing it since 1992. it is not new. this is the first time i have seen something that acts as a solution to a bigger problem of helping people retained independent lives. i do believe that what happened in new york is quite remarkable. you can look at the statistics i mentioned earlier.
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you can have conversations with the people in new york about it. it has had such a positive impact. not everything is going to be perfect. i do my job is trying to get to as perfect as we can. i think this is a good way of helping people get independence. if people want to help, it is there for them. right now, i do not think it is. i believe that prisons can make situations like this so much worse for individuals when they do not get the help they need. if we can help them in an assisted outpatient treatment or and our communities, that is the way we should do it. our goal should be for everyone to live safely and independently. aot is the answer. for a lot of people, it is. this is a law that we should pass in the


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